Healthcare Provider Details

I. General information

NPI: 1932408911
Provider Name (Legal Business Name): HETALBEN SONI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 03/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3391 BATTLEGROUND AVE
GREENSBORO NC
27410-2401
US

IV. Provider business mailing address

4706 RIDGEFALL RD
GREENSBORO NC
27410-9748
US

V. Phone/Fax

Practice location:
  • Phone: 336-282-0556
  • Fax:
Mailing address:
  • Phone: 336-632-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number19334
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: